Descemet Stripping Endothelial Keratoplasty Outcomes in Patients With Rheumatoid Arthritis

PURPOSE To review the graft and visual outcomes in a series of patients with rheumatoid arthritis (RA) who underwent Descemet stripping endothelial keratoplasty (DSEK). METHODS In this case series, the electronic medical records at Wills Eye Hospital were queried for cases of patients with RA who underwent DSEK between January 1, 2009 and September 1, 2018. Charts were reviewed to obtain demographic data, medical history, ocular history, surgical variables, graft survival, and visual acuity outcomes. RESULTS During the study period, 22 transplants performed in 18 eyes of 15 patients with RA were eligible for inclusion. The mean age at the time of initial DSEK was 70.5 ± 11.1 years (range 46-87). The mean follow-up time for the included eyes was 4.89 ± 2.71 years (range 1.95-10.39). The overall estimated graft survival was 8.26 ± 0.81 years with a 5-year survival rate of 88.9%. A significant improvement from preoperative best corrected visual acuity (logarithm of the minimum angle of resolution 0.84, approximately 20/140) to the most recent follow-up (logarithm of the minimum angle of resolution 0.29, approximately 20/40) was noted (P < 0.001). CONCLUSIONS In our case series, patients with a history of RA underwent successful DSEK with excellent graft survival rates and visual acuity outcomes. Well-controlled RA should therefore not be considered a deterrent to performing DSEK.